Doctor Name: | ANGEL BARRAZA |
NPI Number: | 1205919529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCDP |
License Number: | LCDP00243 |
Business Practice Address: | 51 Clay St Central Falls, RI - 028633029 |
Business Phone Number: | 4017268080 |
Business Fax Number: | 4017268087 |
Mailing Address: | 51 Clay St, CENTRAL FALLS |
State: | RI |
Postal Code: | 028633029 |
Phone Number: | 4017268080 |
Fax Number: | 4017268087 |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LCDP00243 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |